Shortage of doctors due to expensive schools?

A medical student checking blood pressure on an awareness drive (Kilbosh)

"We're hearing a lot of anxieties from specialists who don't know what the right thing to do is for their patients," said Megan Ranney, an emergency physician in Rhode Island. "Dermatologists, ophthalmologists, we're even hearing from Dentists."

The doctors were not educated against an invisible enemy named severe acute respiratory syndrome coronavirus 2.

In the past three months, more than 1.3 million people worldwide have been infected with the coronavirus. Doctors and other medical personnel try to save patients from the pandemic that first appeared in Wuhan.

Unfortunately, like other humans, medical personnel are not immune from coronavirus infection. In Spain, Time reported there were around 15 thousand medics infected with the coronavirus. The world is now threatened with a shortage of medical personnel.

Referring to Bloomberg, Vice President Mike Pence announced a new regulation that allowed medical personnel to practice across the states. Even New York Governor Andrew Cuomo asked retired doctors to return.

Pence and members of the White House Coronavirus Task Force brief the media in March 2020 (The White House)
The Economic Times reported that the Indian government was exploring the possibility of passing the final year medical students to go straight into the field against coronavirus diseases 2019 (COVID-19).

"India is the only country in the world which, just by changing MCI regulations can produce over 1.5 lakh doctors and specialists out of thin air," said Devi Shetty, the founder of Narayana Health.

The shortage of doctors actually does not only appear when a pandemic strikes. Many countries in the world indeed lack doctors and medical personnel. According to data from the World Health Organization (WHO), as a developed country, the United States (US) only has 26 doctors per 10 thousand population. The United Kingdom has 23 doctors per 10 thousand population.

According to the data, more than 40 percent of the WHO members reported having less than 10 doctors for every 10 thousand population. In fact, 26 percent stated that they had less than three doctors per 10 thousand population.

The WHO itself recommends that each country has at least one doctor per one thousand population. That is, if a 10 thousand population ratio is used, the country must have at least 10 doctors.

Flag of WHO (United States Mission Geneva)

COVID-19 shows the lack of doctors in the world. Does it have anything to do with expensive tuition?

"I expected a career in medicine partly to be a ticket out of the working-class circumstances I grew up in. My parents, immigrants from rural Iran, struggled to provide opportunity for their children. A career in medicine promised a better future ahead," wrote Farzon A. Nahvi, an emergency medicine physician in New York City in his opinion at The New York Times. "Upon graduation from medical school in 2013, I owed approximately $180,000 in student debt," admitted Nahvi.

After graduating from college and becoming a doctor, Nahvi was required to pay three thousand dollars in installments per month. Five years later, the installments never paid off even though he had tried in various ways, for example, by saving expenses.

In a wealthy country like the US, being a doctor is still too high a dream. The New York Times reported that medical schools are dominated by children born from high economic circles. Ten years ago, 75 percent of total medical students in the US came from the elite with an average parent income of over 75 thousand dollars per year. Today, the fact is not much different.

In general, referring to the Association of American Medical Colleges, for the school year 2019-2020, someone who intends to become a doctor in the US must prepare at least 37,556 dollars per year. Other data, referring to Statista, to study medicine at the University of California, Berkeley, local residents must prepare 14,253 dollars a year. If other citizens want to obtain a medical degree there, a fund of 44,007 dollars must be prepared.

South Hall (UC Berkeley) (Falcorian)

Unfortunately, such an amount is merely an annual fee. Before graduating from high school, various preparatory must be paid. Still referring to The New York Times, people who wish to register for the medical school must prepare a fund of 315 dollars for registration at the Medical College Admission Test, 170 dollars as a preparation fee, and 40 dollars if the person wishes to enroll in more than one university. Then, there is a fee of 200 dollars when the future doctor is called for an interview by the university.

When you become a medical student, funds of up to one thousand dollars must be prepared to buy practical supplies. When graduating, there are a series of tests to get a practice license that requires high costs.

In short, being a doctor requires high costs. As a consequence, according to Nahvi, many medical graduates are reluctant to work as specialized low-paid doctors or serve in poor areas.

"Young physicians are avoiding careers in lower-paying specialties, from pediatrics to psychiatry," stressed Nahvi. "Instead, they are flocking to high-paying specialties like cardiology."

Elisabeth Rosenthal, a doctor who later chose to become a journalist, revealed that doctors were generally highly paid. However, there are also those who have to suffer from the wages they receive. Low-paid doctors are those who work in poor or rural areas who help solve health problems such as drug addiction and other diseases typical of those areas.

In 2018, New York University announced that it was waiving the cost of medical tuition for all its students starting in the 2019-2020 academic year. The question then is, will those medical school graduates, whose tuition fees have been cut off, serve in the areas?

What unique is, if many countries in the world have problems with medical education which is expensive and only able to reach the upper classes, Cuba is different. A few years after the Cuban Revolution, Fidel Castro revolutionized its health system.

Poster advertising a mass to pray for Castro's health on a wall in Bogota in 2007 (Julián Ortega Martinez)

Health and education are the citizens' rights. To become a doctor in Cuba, almost no fees are needed. Certificates from Cuban medical education institutions can also be accepted everywhere, including the US.

Time reported that Cuba was one of the most educated countries in the world. The number of its doctors is also large, tripling the number of doctors per capita in the US. With such an abundance of doctors, Cuba sends them to various parts of the world in need.

Until now, there are about 50 thousand doctors from Cuba who work as medical workers in 67 countries. They successfully generate foreign exchange for up to 11 billion dollars every year.